Seniority question and WWYD in this situation?

lpnflorida · Apr 5, 2009

Senority has little to do with your situation. Your title supercedes an LPN yet I do not feel seniority or title has anything to do with the working as a team. Try sitting down and talking with her directly about what you feel you need of her. My thoughts also are, yes she should not have taken as many breaks as you described. She was not insubordinate by her response, it simply showed reluctance to not quickly say yes I will do it for you. You come in towards the end of her shift, so I do not know what her duties and the expectations are that she has before you arrive.

mondkmondk · Apr 5, 2009

Thank you for your response. She nor the DON's have ever told me what is expected of her duty-wise while she is on the beginning of my shift. I plan to talk to her tomorrow; one problem is that she gets very offended and defensive easily. I don't want her to think ill of me just because I want to know what she is supposed to do and if I'm not supposed to ask her to do stuff or what...I do know that she is best friends with the A-DON, and I do need my job, if you get my point. If we don't have a satisfactory (to me) talk tomorrow then I will talk to the head DON Monday and just see what is expected of her. Perhaps MY expectations are too high or whatever.

Anyway, thanks again!

Blessings, M.

Nascar nurse, ASN, RN · Apr 5, 2009

I would caution you to keep the RN/LPN titles out of this tho. In LTC you will make enemies quickly with the "I am the RN" attitude. (I have been both, LPN for many years and now RN for several years in LTC). Everybody is on the same team.

CoffeeRTC, BSN, RN · Apr 5, 2009

Not a issue of seniority, but job descriptions.

The only way a title has an effect is if you are expected to be the supervisor over her. Any way, you should know what your and her duties are for each shift.

What does she do when you are there? How many pts do you have? do you split them or does she have her own assignment?

mshappy1 · Apr 5, 2009

The title does make a difference if the RN is ultimately responsible for the unit, and that includes what the LPNs do. Look at the LPN PD to find out what her scope of practice is. Talk to her and give her a detailed assignment for the 4 hours she is with you. I'm all for team work, but if the RN will be held accountable for what everyone does, they should be doing it.

NotFlo · Apr 5, 2009

I don't understand how things are set up in your facility. Are you the RN supervisor for the building? Does the LPN have her own assignment?

If you both have an assignment I don't understand why you'd be asking her to get accuchecks for your assignment. Why would you both be assigned to the same patients? I'm confused.

HippyGreenPeaceChick · Apr 5, 2009

I have worked in a LTC facility that I just loved until very recently. I have only worked there since last July. I work evenings, every other weekend only. Occasionally, I have an LPN working with me which should be nice but it is not. She does 12 hour shifts so I have her until 6pm (Evening shift starts at 2p). She has been there a year longer than I have. I'm an RN...who would have seniority? I would like to be able to talk to her and tell her I need more help from her than what I am getting. I really want to talk to her first before going to the DON. From the time she gives me report to the time she leaves, she takes about 6 smoke breaks (our facility mandates one 15 minute break then your one 30 min. lunch break), and the one time I asked her to do a couple of accuchecks for me she gave me a dirty look and said "I guess I will". What would you all do in this situation? Thanks in advance!
Blessings, M.

With all the tax increases in cigarettes, I would by her a box of NicoDerm patches and a box See's chocolates. And be friendly, to help build a work relationship.

carla71 · Apr 5, 2009

IN the LTC facility it is not like the hospital. However many resident's are on your floor that is how many you have. Sometimes things can get crazy and if there is another nurse on the floor, it is nice to have a helping hand. I know where I work, I went in one evening to finishing up some paper work that I didn't finish before I had to leave for a class. The Evening nurse that was on was doing rounds with a doctor and hadn't done her bloodsugars yet, so i asked her if she wanted some help. It is all about consideration and working as a team. Not about what your assignments are. It makes life at the LTC much better. Also, It is what is best for the resident's that live there. Just being there taking advantage of the last 4 hours and smoking whenever you want is not acceptable. She could be doing things that benefit the resident's.

I think sitting down with her on a professional level is a great idea. Her response just depends on how mature she is?

NotFlo · Apr 5, 2009

Of course I agree teamwork is a wonderful thing, but it almost sounds like the original poster feels as if the LPN is obligated to do certain tasks on the RNs assignment simply because she's an LPN. If I'm mistaken or misunderstood, I apologize, but that is the gist of what I was getting. I work in LTC and I'm very lucky that on my floor the other floor nurse and I work very well together and always help each other with whatever needs to be done. I just don't think an RN can expect an LPN to do fingersticks if the LPN has her own patient assignment just because she's an LPN though.

I have no idea how it works in this LTC facility. Perhaps it's possible that on one assignment there's an RN, and LPN and some CNAs all caring for the same patients. I've never seen a LTC facility set up like that but I guess it's within the realm of possibility. If that's the case, then of course the LPN should be doing whatever she's assigned to do for those patients.

There's a chronic smoking break problem at my facility. It effects the CNAs right up to some of the RN supervisors (the ones that smoke). Try paging the only RN in the buliding on nights or weekends for a code or other emergency and getting no response because they're out on their 6th smoke break of the day. It's really problematic. I usually take one ten minute break to get a drink and some food, yet many of the smokers take their lunch, two fifteens, and a couple other "quickie" smoke breaks.

Nascar nurse, ASN, RN · Apr 6, 2009

The title does make a difference if the RN is ultimately responsible for the unit, and that includes what the LPNs do. Look at the LPN PD to find out what her scope of practice is. Talk to her and give her a detailed assignment for the 4 hours she is with you. I'm all for team work, but if the RN will be held accountable for what everyone does, they should be doing it.

I would agree with you IF the OP stated she was ultimately responsible for the unit - but she did not say that. She presented it as if they were just coworkers. I was understanding her to ask if she had more senority just because she was an RN (which is why I stated to be cautious with using the RN title). No matter the title, be it, CNA, LPN, RN, DON, ED or the housekeeper, we are all there to care for residents and this requires teamwork. I was merely stating that flipping titles around usually meets more resistance than simply talking thru expectations and following chain of command if needed.

mondkmondk · Apr 6, 2009

Okay...where we work there are 3 different nursing stations, each station has between 20-30 residents. Station 2 and 3, which I'm responsible for, are right next to each other and station 1 is in a whole other part of the building. On day shift, each station has a charge nurse, but on evening shift, I am in charge of 2 and 3 and the supervising RN and also as the "charge nurse" meaning my duties include passing narcs, breathing treatments, finger sticks and insulins, documentation of those on ATB's and those that are Medicare A people. She is supposed to help me with whatever I need help with. She used to come to me and say "You do the nursing part and I'll do the rest" I never know what she means by that. Our duties all pertain to nursing. Tonight I came in late and she was preparing to go home....she had most everything done or caught up so I know she is capable, but I really feel like I'm being taken advantage of here because when I come in at normal time, she jets instantly out to the smoke shack. One day we had a readmit on station 3 and she handed me the paperwork and told me I needed to do it because she was sick of always having to do them. So I told her I would if she would do my accuchecks for me and that is when she said "I guess I will". I have been a CNA, CMT, LPN, and now RN. I'm not the type of RN to shove my title in someone's face; I just thought that I should be able to ask her to do things and she should be expected to do as I ask. I will get it all straightened out tomorrow with the DON....just to ask for a copy of her job duties and a copy of mine.

Blessings, Michelle